Pubdate: Thu, 04 Jan 2007
Source: Economist, The (UK)
Copyright: 2007 The Economist Newspaper Limited
Bookmark: (Heroin)
Bookmark: (Walters, John)


Much Gain, Less Pain

How One Country's Problem Could Ease the World's Suffering

An Abundance of Deadliness

SOPHIE-MARIE SCOUFLAIRE, the chief pharmacist for the French
humanitarian agency Mdecins Sans Frontires, has spent a lifetime
watching people in disaster-stricken areas of the world writhing in
pain.and she has put in many hours frantically trying to procure
enough opiates to relieve her patients' agony.

That is surprisingly hard. Part of the trouble is that most countries
are allowed under a United Nations regime to import only a very small
quantity of narcotics for medical use.and governments are often slow
to apply for an increase in their quotas. Sometimes, sincerely or
otherwise, they say they doubt their own capacity to handle increased
quantities of drugs. So in a real disaster MSF has to beg the local
health ministry to seek an increase. And in places where no government
exists, MSF doctors go straight to the UN for permission to import
drugs on their own responsibility. But that process is burdensome.

Now compare the dire shortage of medical opiates that afflicts the
poorest parts of the world with the deeply unwanted surplus of poppies
that has just been gathered in Afghanistan. According to Antonio Maria
Costa, director of UNODC, the UN drugs and crime agency, the 2006
harvest was a record; both the acreage sown and total output have
risen sharply. Farmers have harvested about 6,000 tonnes, amounting to
90% of total world output.

Afghanistan's President Hamid Karzai, pointing to the links between
the resurgent Taliban and the drug business, has called the opium
trade his country's "worst enemy". But farmers, flush with cash, have
already been planting new crops. In response the American anti-drugs
chief, John Walters, said last month that the United States planned to
wipe out the crop by spraying the seedlings.

In defence of such an indiscriminate approach, it is pointed out that
less drastic measures, aimed at persuading farmers to switch to legal
crops, have failed. The farmers earn around three times as much from
opium than from other crops; many say that they cannot support their
families without the income they receive. And some complain that the
Americans have already started spraying.

But a think-tank with offices in Europe and Kabul has made an
alternative suggestion. Emmanuel Reinert, director of the Senlis
Council, says Western governments should start pilot projects, at
least, as a first step towards licensed poppy-growing to make
essential medicines. He believes that it will prove impossible to
eradicate opium production, and that trying to do so will play into
the Taliban's hands. He also believes that by turning opium fields
over to medicine production, the current shortage of opium-based
medicines will be solved. The statistics cited in favour of this idea
are indeed startling. UNODC figures for 2005 suggest that 80% of the
world's population had hardly any access to morphine or other

There are plenty of counter-arguments: would it ever be possible to
offer farmers more money to sell their crop for medical uses than they
now get from drug lords? Christopher Langton, an analyst with the
International Institute for Strategic Studies in London, thinks
licensing could work if it were introduced cautiously, using a mixture
of carrot and stick. As he puts it: "If a farmer is faced with the
choice of eradication or production under licence, he might
compromise." But allocating licences would be a contentious affair,
and might add to ethnic strife if badly managed.

Supporters of licensed production cite the example of Turkey, where in
1970 the government faced American demands for complete eradication of
poppy farming. Suleyman Demirel, who was then prime minister, retorted
that this would be bitterly unpopular, and successfully
counter-proposed that the crop should be diverted to medical use.

Perhaps part of the solution might lie in an Australian discovery: a
firm in Tasmania has made a variety of poppy in which the synthesis
that leads to morphine is interrupted at the last moment. That makes
the poppies more useful for the production of pain-killers and less
handy for making heroin. If that does not work, here is an even bolder
idea: an American security writer, Walton Cook, has argued that simply
paying every Afghan farmer not to grow poppies would be cheap compared
with the social cost of heroin use.